Journal of Rehabilitation Research and Development 

About: Journal of Rehabilitation Research and Development is an academic journal. The journal publishes majorly in the area(s): Population & Veterans Affairs. It has an ISSN identifier of 0748-7711. It is also open access. Over the lifetime, 2273 publications have been published receiving 100851 citations.

Treadmill training of paraplegic patients using a robotic orthosis

Abstract: Recent studies have confirmed that regular treadmill training can improve walking capabilities in incomplete spinal cord-injured subjects. At the beginning of this training the leg movements of the patients have to be assisted by physiotherapists during gait on the moving treadmill. The physical capabilities and the individual experience of the therapists usually limit this training. A driven gait orthosis (DGO) has been developed that can move the legs of a patient in a physiological way on the moving treadmill. The orthosis is adjustable in size so different patients can use it. Actuators at the knee and hip joints are controlled by a position controller. With the DGO the legs of patients with different degrees of paresis and spasticity could be trained for more than half an hour, and physiological gait patterns were obtained.

Constraint-Induced Movement Therapy: a new family of techniques with broad application to physical rehabilitation--a clinical review.

Abstract: A new family of rehabilitation techniques, termed Constraint-Induced Movement Therapy or CI Therapy, has been developed that controlled experiments have shown is effective in producing large improvements in limb use in the real-world environment after cerebrovascular accident (CVA). The signature therapy involves constraining movements of the less-affected arm with a sling for 90% of waking hours for 2 weeks, while intensively training use of the more-affected arm. The common therapeutic factor in all CI Therapy techniques would appear to be inducing concentrated, repetitive practice of use of the more-affected limb. A number of neuroimaging and transcranial magnetic stimulation studies have shown that the massed practice of CI Therapy produces a massive use-dependent cortical reorganization that increases the area of cortex involved in the innervation of movement of the more-affected limb. The CI Therapy approach has been used successfully to date for the upper limb of patients with chronic and subacute CVA and patients with chronic traumatic brain injury and for the lower limb of patients with CVA, incomplete spinal cord injury, and fractured hip. The approach has recently been extended to focal hand dystonia of musicians and possibly phantom limb pain.

Systematic review of the effect of robot-aided therapy on recovery of the hemiparetic arm after stroke.

Abstract: Spinal orthoses are common in the treatment of various conditions that affect the spine. They encompass both the spine and pelvis and thus have implications for pelvic and lower-limb motion during walking in addition to a direct effect on spinal motion. The role of the spine in walking is largely ill-defined, and the consequences of restricted spinal motion on walking have yet to be explored. This study investigated the effect of spinal restriction on gait in able-bodied persons. Gait analyses were performed on 10 able-bodied subjects as they walked at five different speeds that were distributed across their comfortable range of speeds. Data were collected during walking with and without spinal restriction by a fiberglass body jacket, which is similar to a thoracolumbosacral orthosis (TLSO). With spinal restriction, peak-to-peak (PP) pelvic obliquity and rotation were significantly reduced across all walking speeds (p < 0.001), while PP pelvic tilt was significantly reduced at only the fastest walking speeds (p = 0.017). PP hip abduction-adduction motion was significantly reduced with spinal restriction across all speeds (p < 0.001), while PP hip flexion-extension significantly increased at only the slow and very slow speeds (p < 0.001 and p = 0.023, respectively). A better understanding of the effects of restricted spinal motion on gait may help clinicians predict and avoid development of additional problems from TLSO use or surgical restriction of spinal motion. An awareness of these issues will enable clinicians to monitor patients for problems that may result from decreased spine and pelvic motion.

Basic gait parameters: reference data for normal subjects, 10-79 years of age

Abstract: Basic gait parameters were extracted from 233 healthy subjects--116 men and 117 women, 10 to 79 years of age. The measurements were made in a gait laboratory on a 5.5 m walkway. The results are presented in a series of reference tables for slow, normal, and fast gait. Mean, standard deviation, coefficient of variation, 95% confidence intervals, and 95% prediction intervals were calculated. Significant sex differences exist in all gait parameters. In a two-way analysis of variance (ANOVA) model, there was a statistically significant age-variability for gait speed and step length at normal and fast gait, but not for step frequency. In the step length parameter there was a significant interaction effect of age and sex at normal and fast gait. The reference data are considered valid in an indoor laboratory situation.

Electromyogram pattern recognition for control of powered upper-limb prostheses: state of the art and challenges for clinical use.

Abstract: Using electromyogram (EMG) signals to control upper-limb prostheses is an important clinical option, offering a person with amputation autonomy of control by contracting residual muscles. The dexterity with which one may control a prosthesis has progressed very little, especially when control- ling multiple degrees of freedom. Using pattern recognition to discriminate multiple degrees of freedom has shown great promise in the research literature, but it has yet to transition to a clinically viable option. This article describes the pertinent issues and best practices in EMG pattern recognition, identifies the major challenges in deploying robust control, and advocates research directions that may have an effect in the near future.